The action of Platelet and Leukocyte Rich Fibrin (L-PRF) on bone neoformation – A systematic review

Background

PRF was developed by Choukroun to be used in oral and maxillofacial surgery and, in the Dental Medicine field, it has various applications such as the increase of bone tissue for implantology, sinus lift, alveolar bone graft, periodontal surgeries and others. The present systematic review addresses the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) in bone neoformation.

Aim/Hypothesis

The objective of this review was to determine if the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) produces beneficial effects for bone neoformation.

Material and Methods

Electronic databases (PUBMED, EMBASE COCHRANE, LILACS and CINAHL) were retrospectively consulted through 2003, using the following keywords- Rich Platelet-Leukocyte Fibrin and Leukocyte and Platelet-Rich Fibrin. During the selection of the studies, the evaluation of the titles and abstracts identified in the initial search was done by two researchers, independently and blinded. At that time, 34 articles were collected that addressed the relationship of Rich Fibrin in Platelets and Leukocytes in bone neoformation. Articles identified by the initial search strategy were independently assessed by the two researchers, according to the following inclusion criteria-(1) population (human) + (2) dental surgical intervention and+(3) presented histomorphometric studies.

Results

As a result of the search criteria according to the following inclusion criteria- (1) population (human), (2) dental surgery and (3) presented histomorphometric studies, a single article was selected- Platelet-rich fibrin (PRF)- A second-generation platelet concentrate. Part V- Histologic evaluations of PRF effects on bone allograft maturation in sinus lift (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 299–303). In this study, the authors performed nine sinus level increases. At 6 sites, L-PRF was added to FDBA particles (test group) and at 3 sites FDBA was used without PRF (control group). Four months later for the test group and 8 months later for the control group, bone samples were collected from the increased region during the implant insertion procedure. These specimens were treated for histological analysis. The authors showed that in cases of sinus floor enlargement with FDBA associated with L-PRF leads to a reduction in healing time before implant placement

Conclusion and Clinical Implications

This work shows that there are numerous articles that demonstrate that the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) produces beneficial effects for bone neoformation. However, there is a need for more large-scale studies, combining the following inclusion criteria in the same article- (1) population (human), (2) dental surgery and (3) histomorphometric studies.